1、HIE发生发展及影像诊断发生发展及影像诊断概述诊断侧重点：是否有损伤损伤分级（重度 vs.轻中度？）及范围损伤所处的阶段及预后1.鉴别诊断Time-signal curve in TII24h Location of voxels and normal neonatal proton spectra.A,The deep gray nuclei voxel includes most of the lentiform nucleus,the ventrolateral thalamus,and the posterior limb of the internal capsule.The spe
2、ctrum reveals:1)a small myoinositol peak,2)a large choline peak,3)two small creatine/phosphocreatine peaks,and 4)a medium-sized NAA peak.B,The watershed voxel includes primarily white matter from the intravascular boundary zone.Note that the NAA and choline peaks are relatively smaller in the less m
3、ature watershed zone than in the more mature deep gray nuclei.Minimal or no lactate was seen in most patients who were developmentally normal at 12 months.Neonatal asphyxia in a term neonate.Short-echo-time(30 msec)(a)and long-echo-time(135 msec)(b)MR spectroscopic images obtained on day 1 of life w
4、ith a voxel positioned in the right basal ganglia show a lactate(Lac)doublet centered at 1.3 ppm in a and an inverted lactate doublet in b.There is also elevated glutamine-glutamate(Glx)in a and low NAA in b.Cho choline,Cr and Cr2 creatine resonances(3.0 ppm and 3.9 ppm,respectively).Neonate with basal nuclei pattern of injury.A and B,The basal nuclei voxel(A)shows marked elevation of the lactate peak(L)centered at 1.31 ppm.In this acute phase,the relative sizes of the choline,creatine,and NAA peaks are normal.The watershed voxel(B)shows less elevated lactate(compare with A)
